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Global Refugees Checklist
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Overview of Malaria

Migrants who have lived or travelled in malaria-endemic areas are vulnerable to acute malaria, particularly within the first three months after arrival. Symptoms of malaria (malaise, myalgia, headache and fever) are nonspecific, and primary care practitioners should be vigilant for symptoms of malaria:

Key Recommendations:

Quality of Evidence: LOW

Balance of benefits and harms Values and preferences
  • The focus of recommendations is on timely diagnosis and treatment of symptomatic malaria, where medications are effective and harms from adverse effects are minimal.
  • Individuals from malaria endemic regions, particularly migrants from sub-Saharan Africa, remain vulnerable to acute Plasmodium falciparum malaria for the first 3 months after arrival.
  • Clinical trials demonstrating the value of routine screening for asymptomatic malaria are lacking, prevalence data remain poor, the performance characteristics of malaria screening tests in asymptomatic individuals are uncertain, and local transmission of malaria is nonexistent in Canada.

The committee:

  • determined that malaria was best addressed by primary care practitioners remaining alert for signs and symptoms of the disease and performing timely clinical diagnostic inquiry and treatment of symptomatic individuals

Attributed more value to:

  • avoiding burden and cost from routine screening in the absence of clear evidence of prevalence of P. falciparum
  • avoiding burden and cost uncertainty of performance of screening tests in asymptomatic individuals

Links to Other Learning Resources

Pottie K, Greenaway C, Feightner J, Welch V, Swinkels H, Rashid M, Narasiah L, Kirmayer L, Ueffing E, MacDonald N, Hassan G, McNally M, Kahn K, Buhrmann R, Dunn S, Dominic A, McCarthy AE, Gagnon AJ, Rousseau C, Tugwell P and co-authors of the Canadian Collaboration for Immigrant and Refugee Health. Overview: Evidence-based clinical guidelines for immigrants and refugees. CMAJ 2011; 183(12):E824-E925.

Design and Production: Centre for e-Learning, Teaching and Learning Support Service (TLSS), University of Ottawa